Peer Support

by Celeste Florentin, MSW

Long before the SARS-CoV-2 virus appeared, peer support groups were proliferating across the United States, frequently taking place in person though also offered virtually and even over the phone. Certified peer specialists have played an integral role in Wisconsin’s mental health system since 2010, when the first cohort of peers successfully completed the state certification exam.

Substance Abuse and Mental Health Services Administration (SAMHSA) defines peer support as “encompass[ing] a range of activities and interactions between people who share similar experiences of being diagnosed with mental health conditions, substance use disorders, or both.” In other words, people who share a characteristic, such as a mental health diagnosis, support each other in various ways by talking about their lived experiences and offer hope, help, and support to each other. A key element that distinguishes peer support from a more traditional therapy model is that peers are equals, rather than a patient seeking advice from an expert.

The first time I encountered the phrase peer support was around five years ago while reading an article in a local paper. Peers, as in a jury of one’s peers or as it was used interchangeably with the word classmates by my teachers when I was in school, was just another vocabulary word whose deeper meanings and associations I had never had the time nor need to internalize. I first came to understand the function of peer support in the same way many people do, as a consumer myself.

The first peer support group I attended was full of strangers with kind faces and sad eyes. As I listened to the facilitators welcome participants, and as people began to share, I realized I had never experienced anything like this gathering. It was as if we had created a separate universe where stigma and disapproving stares couldn’t penetrate—where people spoke freely of their diagnoses, medications, and hospitalizations without fear. At the beginning of the meeting, it was unimaginable to me that I would say anything more than my name, but when the facilitator finally asked me if I was ready to share, I felt perfectly safe and comfortable

disclosing my most personal feelings to a room full of people I had just met an hour earlier. Several years later, it’s no exaggeration to say that peer support groups saved my life—a refrain I have heard countless times from countless others over the years.

The concept of peer support became popularized in the United States during the social upheaval that characterized much of the 1960s and 70s. The Mental Patients Liberation Front recognized the humanity and inherent right to dignity and self-determination that had been systematically denied to people deemed by the state to be incapable of caring for themselves. Former patients and survivors of the mental health system formed their own independent groups to talk about their experiences and find new ways to support each other that didn’t rely on the expertise of a professional. In San Francisco, peers created a newsletter, Madness Network News, dedicated to sharing stories and forcefully opposing forced psychiatric treatments, such as electroshock therapy and lobotomies. The collective advocacy of these groups and the benefits of peers supporting each other became a cornerstone of the mental health consumers’ movement.

There are several elements of peer support that distinguish it from traditional therapy or case management. While no two peer support groups are the same, many of them share a commitment to trust and confidentiality, a recognition that peers are the experts on their own lives, acceptance and understanding of others’ struggles, and seeing the person as a whole and unique individual (not just as their diagnosis).

In addition to learning more about themselves and learning new ways to cope, peers who attend support groups benefit from increased social support and growing their support network. While research into peer support groups is ongoing, many studies have already demonstrated the benefits of peer support. Research has shown that regularly attending peer support groups leads to decreased hospitalizations, more engagement with one’s community, improved ability to advocate for oneself with doctors and mental health professionals, and an increase in hope for the future. So many of the benefits of peer support come directly from the interactions among group participants. Peers attend groups at all stages of their recovery and can serve as a model for recovery and success for others.

Several studies have shown that peers who share their stories benefit even more from the interaction than the person who listens to their story. This is perhaps due, at least in part, to finding that their lived experience is valuable to others. In my own experience, simply bearing witness to another’s story demonstrates care and curiosity that can be hard to find outside of peer spaces. Because negative stigma continues to be so pervasive, creating an open forum where people can talk about the realities of their lives without having to explain or defend themselves is a rare and vital source of safety.

Peer support groups range widely in focus; there are peer support groups for people struggling with substance use, people living with a mental illness, family members of people living with a mental illness, people grieving the loss of a loved one, cancer patients, and innumerable others. While the content and structure of individual groups varies greatly from one to the next, the central focus of peer support is to provide a safe, supportive, and confidential environment. NAMI Dane County’s peer support groups center the group participants and affirm that, as isolating as living with a mental illness can feel, participants are not alone in their struggles.

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Celeste Florentin, MSW, is the program and outreach coordinator at NAMI Dane County.